Tan B P, Hannah M E
Cochrane Database Syst Rev. 2007 Jul 18(2):CD000178. doi: 10.1002/14651858.CD000178.
Induction of labour after prelabour rupture of membranes may reduce the risk of neonatal infection. However an expectant approach may be less likely to result in caesarean section.
The objective of this review was to assess the effects of induction of labour with prostaglandins versus expectant management for prelabour rupture of membranes at or near term.
We searched the Cochrane Pregnancy and Childbirth Group trials register.
Randomised and quasi-randomised trials comparing early use of prostaglandins (with or without oxytocin) with no early use of prostaglandins in women with spontaneous rupture of membranes before labour, and 34 weeks or more of gestation.
Trials were assessed for quality and data were abstracted.
Fifteen trials were included. Most were of moderate to good quality. Different forms of prostaglandin preparations were used in these trials and it may be inappropriate to combine their results. Induction of labour by prostaglandins was associated with a decreased risk of chorioamnionitis (odds ratio 0.77, 95% confidence interval 0.61 to 0.97) based on eight trials and admission to neonatal intensive care (odds ratio 0.79, 95% confidence interval 0.66 to 0.94) based on seven trials. No difference was detected for rate of caesarean section, although induction by prostaglandins was associated with a more frequent maternal diarrhoea and use of anaesthesia and/or analgesia. Based on one trial, women were more likely to view their care positively if labour was induced with prostaglandins,.
AUTHORS' CONCLUSIONS: Induction of labour with prostaglandins appears to decrease the risk of maternal infection (chorioamnionitis) and admission to neonatal intensive care. Induction of labour with prostaglandins does not appear to increase the rate of caesarean section, although it is associated with more frequent maternal diarrhoea and pain relief.
胎膜早破后引产可能会降低新生儿感染风险。然而，期待疗法导致剖宫产的可能性可能较小。
本综述的目的是评估在足月或接近足月时，使用前列腺素引产与胎膜早破期待治疗的效果。
我们检索了Cochrane妊娠与分娩组试验注册库。
随机和半随机试验，比较在临产前胎膜自然破裂且妊娠34周或以上的妇女中，早期使用前列腺素（加或不加缩宫素）与不早期使用前列腺素的情况。
评估试验质量并提取数据。
纳入了15项试验。大多数试验质量为中等至良好。这些试验中使用了不同形式的前列腺素制剂，合并其结果可能不合适。基于八项试验，前列腺素引产与绒毛膜羊膜炎风险降低相关（比值比0.77，95%置信区间0.61至0.97）；基于七项试验，与新生儿重症监护病房收治率降低相关（比值比0.79，95%置信区间0.66至0.94）。剖宫产率未发现差异，尽管前列腺素引产与产妇腹泻更频繁以及麻醉和/或镇痛药物使用增加相关。基于一项试验，若用前列腺素引产，妇女对其护理的评价更积极。
前列腺素引产似乎可降低产妇感染（绒毛膜羊膜炎）风险和新生儿重症监护病房收治率。前列腺素引产似乎不会增加剖宫产率，尽管与产妇腹泻更频繁和疼痛缓解相关。
